Touching Lives - June 2004
Finding the perfect fit
If it caused pain each time you took a step, your quality of life would be severely affected.
There are 600,000 people in Europe who have a lower limb amputation as a result of diabetes, cancer, circulatory and vascular diseases, or because of an accident. Some 70 per cent of these people have an artificial lower limb below the knee and for years doctors and prosthetists have studied how to get the best fit.
A major problem is discomfort at the socket, where the prosthesis joins the body, but now £78,000 from Action Medical Research is being used to study the pressures between the body and the artificial limb during walking, because uneven pressure on a socket can cause real discomfort.
Dr Brendan McHugh is leading a team at the National Centre for Training and Education in Prosthetics and Orthotics at the University of Strathclyde, Glasgow.
Dr McHugh said, “Over the past 40 years there have been two main ways of producing a prosthesis to get a good fit, usually producing a socket after making an accurate mould of the stump. But even though a lot of work has been done to try and get the best pressure distribution at the socket, there is very little evidence to show which technique is the most successful and why.
“Our study will provide a better understanding of socket fit by examining and comparing pressures between the body and the device during walking.
Every patient is different
“We use a specialist pressure measurement system to acquire this data — but we also issue patients with a questionnaire to obtain their views. Every patient is different and by getting this data we can build up reliable evidence to show what’s most important when it comes to making a socket that fits properly.”
Proving what makes a good socket fit could potentially have an impact on thousands of people in the UK.
“If you rely on a prosthetic lower limb for mobility but cannot get a good fit, you are unlikely to want to use it, and that makes a big impact on your quality of life,” Dr McHugh continues. “The stump can be extremely sensitive; after all, it isn’t designed to bear the weight of the body and we know that many patients simply tolerate their artificial limb because there’s no real alternative. Understanding how to make the perfect socket fit would make a tremendous difference to those people.”